Race does matter: venous thromboembolism in trauma patients with isolated severe pelvic fractures

Liasidis, Panagiotis; Benjamin, Elizabeth; Jakob, Dominik A.; Ding, Li; Lewis, Meghan; Δημητριάδης, Δημήτριος

doi:10.1007/s00068-022-02044-4

Cited by 9 publications

(3 citation statements)

References 46 publications

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“…Length of hospital stay, age, major trauma or fracture, major surgery, and D-dimmer are common and signi cant predictors of DVT in patients [12,29,30]. Liasidis et al [31]pointed out that, despite mechanical and chemical thromboprophylaxis, the risk of DVT in patients with pelvic fractures is still very high, which might be related to long-term immobilization. In addition, the higher the education level of patients, the lower the incidence of DVT, which may be related to the higher acceptance of the disease, thromboprophylaxis knowledge, and the higher compliance with thromboprophylaxis practice.…”

Section: Discussionmentioning

confidence: 99%

Risk assessment scales to predict risk of lower extremity deep vein thrombosis among multiple trauma patients: A prospective cohort study

Chen

Sun

Kong

2023

Preprint

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Background Deep vein thrombosis (DVT) is a common complication in orthopedic patients. Previous studies have focused on major orthopedic surgery.There are few studies with multiple trauma. We aimed to describe the prevalence of DVT and compare the predictive power of the different risk assessment scales in patients with multiple trauma.Methods This prospective cohort study involved multiple trauma patients admitted to our hospital between October 2021 and December 2022. Data were prospectively collected for thrombotic risk assessments using the Risk Assessment Profile for thromboembolism(RAPT), the DVT risk assessment score (DRAS), and the Trauma Embolic Scoring System (TESS), respectively. The receiver operation characteristic (ROC) curve and the area under the curve (AUC) were evaluated to compare the predictive power. Doppler ultrasound was used to determine DVT incidence.Results A total of 210 patients were included, and the incidence of DVT was 26.19%. Distal DVT accounted for 87.27%; postoperative DVT, 72.73%; and bilateral lower extremity thrombosis, 30.91%. There were significant differences in age, education degree, pelvic fracture, surgery, ISS, D-dimmer level, length of hospital stay and ICU stay between the thrombosis group and the non-thrombosis group. The AUCs for RAPT, DRAS, and TESS were 0.737, 0.710, and 0.683, respectively. The RAPT had better predictive value, but there were no significant differences between the three ROC curves.Conclusions The incidence of DVT was relatively high during hospitalization. We prospectively validated the tests to predict risk of DVT among patients with multiple trauma to help trauma surgeons in the clinical administration of DVT prophylaxis.

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Section: Discussionmentioning

confidence: 99%

Risk assessment scales to predict risk of lower extremity deep vein thrombosis among multiple trauma patients: A prospective cohort study

Chen

Sun

Kong

2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Length of hospital stay, age, major trauma or fracture, major surgery, and D-dimer are common and significant predictors of DVT in patients [ 9 , 26 , 27 ]. Liasidis et al [ 28 ] pointed out that, despite mechanical and chemical thromboprophylaxis, the risk of DVT in patients with pelvic fractures is still very high, which might be related to long-term immobilization. In addition, the higher the education level of patients, the lower the incidence of DVT, which may be related to the higher acceptance of the disease, thromboprophylaxis knowledge, and the higher compliance with thromboprophylaxis practice.…”

Section: Discussionmentioning

confidence: 99%

Risk assessment scales to predict risk of lower extremity deep vein thrombosis among multiple trauma patients: a prospective cohort study

Chen,

Sun,

Kong

2023

BMC Emerg Med

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Background Deep vein thrombosis (DVT) is a common complication in orthopedic patients. Previous studies have focused on major orthopedic surgery.There are few studies with multiple trauma. We aimed to describe the prevalence of DVT and compare the predictive power of the different risk assessment scales in patients with multiple trauma. Methods This prospective cohort study involved multiple trauma patients admitted to our hospital between October 2021 and December 2022. Data were prospectively collected for thrombotic risk assessments using the Risk Assessment Profile for thromboembolism(RAPT), the DVT risk assessment score (DRAS), and the Trauma Embolic Scoring System (TESS), respectively. The receiver operation characteristic (ROC) curve and the area under the curve (AUC) were evaluated to compare the predictive power. The whole leg duplex ultrasound of both lower extremities Doppler ultrasound was used to determine DVT incidence. Results A total of 210 patients were included, and the incidence of DVT was 26.19%. Distal DVT accounted for 87.27%; postoperative DVT, 72.73%; and bilateral lower extremity thrombosis, 30.91%. There were significant differences in age, education degree, pelvic fracture, surgery, ISS, D-dimer level, length of hospital stay and ICU stay between the thrombosis group and the non-thrombosis group. The AUCs for RAPT, DRAS, and TESS were 0.737, 0.710, and 0.683, respectively. There were no significant differences between the three ROC curves. Conclusions The incidence of DVT was relatively high during hospitalization. We prospectively validated the tests to predict risk of DVT among patients with multiple trauma to help trauma surgeons in the clinical administration of DVT prophylaxis.

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“…3 A previous study by Liasidis et al (2022) found an increased incidence of VTE, DVT, and PE, specifically among Black patients with isolated severe pelvic fractures compared to White patients. 4 Similarly, Zebley et al found Black trauma patients to have the highest incidence of VTE amongst racial groups despite also being 4% more likely to receive VTE prophylaxis than white patients and having the shortest time to administration. 3 American Indian patients in this study were also 8% less likely to receive VTE prophylaxis.…”

Section: Introductionmentioning

confidence: 96%

Racial Distribution and Associated Outcomes for Patients With and Without Severe-Isolated Traumatic Brain Injuries Following Venous Thromboembolism Prophylaxis

Elkbuli,

Patel,

Breeding

et al. 2023

The American Surgeon™

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Introduction Disparities in venous thromboembolism (VTE) incidence and prophylaxis have been observed across racial groups. This study investigates the relationship between race, injury type, and the timing of VTE prophylaxis in severe trauma patients, both with and without isolated traumatic brain injuries. The primary goal is to analyze how these factors interact and their potential impact on clinical outcomes. Methods A retrospective cohort study of the American College of Surgeons Trauma Quality Program Participant Use File (ACS-TQIP-PUF) from 2018 to 2021. Patient demographics, injury categories, VTE prophylaxis timing, injury severity, and in-hospital complications were collected. Multivariable regression models explored associations between race, injury type, VTE prophylaxis, and in-hospital mortality. Groups were analyzed by injury profile (isolated TBI vs non-TBI) and then by VTE prophylaxis timing (early ≤24 hours, late >24 hours). Results Of 68,504 trauma patients analyzed, the majority were non-Hispanic or Latino (83.3%), White (71.2%), and male (69.6%). Patients receiving late VTE prophylaxis had higher rates of DVT and PE across race groups than patients with early prophylaxis. Logistic regression showed Asian patients with TBI receiving early prophylaxis were significantly more likely to have in-hospital mortality (OR 16.27, CI = 1.11-237.43, P = .04) than other races. Conclusion Patients who received late prophylaxis had higher VTE rates than early prophylaxis, independent of injury pattern or race. Additionally, assessing the implications of race in early VTE prophylaxis for isolated TBI showed that adult Asian patients had 16 times higher odds of in-hospital mortality compared to other races.

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Race does matter: venous thromboembolism in trauma patients with isolated severe pelvic fractures

Cited by 9 publications

References 46 publications

Risk assessment scales to predict risk of lower extremity deep vein thrombosis among multiple trauma patients: A prospective cohort study

Risk assessment scales to predict risk of lower extremity deep vein thrombosis among multiple trauma patients: A prospective cohort study

Risk assessment scales to predict risk of lower extremity deep vein thrombosis among multiple trauma patients: a prospective cohort study

Racial Distribution and Associated Outcomes for Patients With and Without Severe-Isolated Traumatic Brain Injuries Following Venous Thromboembolism Prophylaxis

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